Abstract

IMPACT OF THE ASPERGILLUS SPP. INFECTION IN SEVERE COVID-19 PATIENTS

Antonio Neres Norberg*, Paulo Roberto Blanco Moreira Norberg, Cláudia Maria Blanco Moreira Norberg, Fabiano Guerra Sanches, Fernanda Castro Manhães, Alcemar Antônio Lopes de Matos, Bianca Magnelli Mangiavacchi and Lígia Cordeiro Matos Faial

ABSTRACT

Fungi of the genus Aspergillus are found in all environments on planet Earth, and some species of this genus are pathogenic for humans. The most severe clinical form is invasive infection, mainly invasive pulmonary aspergillosis, which produces high morbidity and mortality in infections secondary to patients with critical health conditions. This research aimed to verify the impact of Aspergillus spp. infections on the prognosis of critically ill COVID-19 patients. The scientific literature currently available indicates that this is an important injury in cases of Severe Acute Respiratory Syndrome caused by SARS-CoV-2 considering the high mortality rates when compared to control groups. Concomitant infections by Aspergillus spp. and SARS-CoV-2 may present interactions between these pathogens which are largely unknown, and the immunomodulatory therapeutic conduct in severe cases by COVID-19 may influence susceptibility to invasive infection by Aspergillus spp. The complications in determining clinical cases of associating infections by SARS-CoV-2 and Aspergillus spp. infections in the acute course of COVID-19, and the degree of impact on mortality and worsening of the acute viral illness indicate that health professionals should not wait for the fulfilment of a diagnostic criterion regarding this secondary infection and that early or preventive antifungal treatment should be applied to avoid worsening or death. The use of multiple diagnostic methods and low-invasive procedures for detection of Aspergillus spp. in the airways of critically ill patients by COVID-19 should be incorporated into treatment protocols to prevent worsening of clinical conditions and prevent mortality of patients in hospital units.

Keywords: COVID-19, SARS-CoV-2, Aspergillus, aspergilosis, secondary infections.